Acute bacterial meningitis is a serious and life-threatening neurological infectious disease. Despite the availability of effective antibiotics, supportive care facilities and recent advances in adjunctive strategies, for example, adjunctive dexamethasone, mortality and morbidity rates associated with bacterial meningitis remain unacceptably high. The review presents a brief overview of key clinical and epidemiological aspects of the disease and focuses on advances in pharmacotherapeutic strategies in adult patients with bacterial meningitis in the developed world.